7 reasons your knees hurt after running and how to fix it

At the end of your run, you might feel a little bit of pain in your knees. Soon, it’s more than just a little bit. You might find yourself wondering what could have happened during your run, which felt fine, to make you so uncomfortable now. There are a variety of reasons why your knees might hurt. At Performance Rehab, a physical therapist can help you find out why your knees hurt after running. Here, we will take a look at seven common issues that might be behind it.

What could cause your knee pain?

A range of issues could be behind the pain in your knees, including pain that begins without injury. These might include:

1. Unusual gait

A proper gait can make running more comfortable, and a minor issue might leave you with sore knees after a run. If your knees don’t feel great at the beginning of a run, or you’re nervous about future discomfort, you might change how you move. Unfortunately, this change might contribute to the pain that you hope to avoid.

A physical therapist can assess your gait while you run and offer advice. Using targeted exercises and movement training, they can help you correct your gait pattern and build stability, so that you run more safely and confidently. They might also make recommendations, like shoes that support your feet or ankles to make maintaining a healthy gait easier.

2. Runner’s knee

Runner’s knee, also called patellofemoral pain syndrome, isn’t an unusual problem. Many runners deal with it and treat it to continue participating in their sport or hobby. One sign that you might have this condition is dull pain between your kneecap and the end of your thighbone (femur). It might feel like an ache. Running might not be the only trigger; you might feel pain when sitting for a long time, squatting or using stairs.

This condition has several possible causes, including muscle imbalances that don’t support patellar alignment. A physical therapist can work with you to address these imbalances. Other causes include injury (like patellar dislocation) and overuse. Physical therapy can be key for increasing flexibility in the legs and hips and strengthening the knees. 

3. Damaged tendons or ligaments

An old or new tendon or ligament injury might be behind the problem if only one knee hurts. These injuries might be caused by a blow to the knee while playing contact sports or the impact of an accident. They may be caused by sudden twists. Possible injuries range from strains or sprains to torn tendons or ligaments. You may not be able to tell whether something is strained, sprained or torn without a medical professional’s assessment. However, a tear may have made a popping sound or caused a lot of bruising to appear quickly.

A physical therapist can help treat a strain or sprain. They can also help you strengthen your knee to keep it healthy afterward. If you have a torn tendon or ligament, you may need surgical treatment. You can rebuild your knee’s strength and reduce pain with a physical therapist.

4. Damaged cartilage

Cartilage serves as a sort of padding inside the joints, protecting the bones from grinding against each other. Cartilage on the bottom of your kneecap, the part that touches your femur, allows it to glide within a cartilage-lined groove on the end of your femur. Overuse or arthritis can damage the cartilage, leading to pain in the knees. Cartilage can also be damaged by an injury like a dislocation or fracture within the joint.

5. Bursitis

Bursitis is inflammation of the bursae, the small fluid-filled cushions in some joints. They help joints move smoothly in addition to cartilage. Each of your knees contains 12 bursae, and any one bursa can become inflamed. It might ache, make your knee stiff, and hurt more with movement or pressure. Your knee may be swollen or red.

Bursitis can generally be treated with rest and ice. A pain reliever may help. A physical therapist can use gentle movement and targeted exercises to reduce inflammation and help you build strength to support your knee. 

6. Arthritis

Over time, the cartilage between joints can wear down. Eventually, this can lead to painful contact between bones, including in the knee joint. It may come with stiffness and pain, especially in cold weather, in mornings or after sitting still for a long time. This is a chronic condition that many people live with.

Treatment may make living with osteoarthritis easier, and a physical therapist can offer many treatment options. These include traditional physical therapy, sports medicine and nonmedication pain relief techniques like cupping.

7. Anatomical differences

Everyone’s body is different, and sometimes those differences are good things. They might give you advantages as a runner. But sometimes, those differences can hold you back. These differences might be misalignments that angle your knees inward or outward, which a physical therapist can help you address through form guidance or strengthening strategies.

Another possible difference is trochlear dysplasia, in which the groove at the end of the femur that holds the kneecap in place is shallow or absent. This may cause patellar instability that could contribute to knee pain or increase risk of injuries like patellar dislocation.

A physical therapist can help you strengthen and support your knees with a plan tailored to your unique personal build. They’ll guide you in understanding how your body moves and how to protect it. If a condition like trochlear dysplasia requires surgical treatment, physical therapy can play a key role in recovery and pain reduction.

Performance Rehab can treat your knee pain

At Performance Rehab, our experienced licensed physical therapists can evaluate your knee pain and create a personalized treatment plan just for you. Connect with our experienced rehab specialists so you can run with more comfort and confidence. Request an appointment or contact us to get started.